| NPI | 1104818822 |
|---|---|
| Former Legal Business Name | EAST VALLEY PEDIATRIC SURGERY |
| Entity Type | Organization |
| Authorized Contact | ENRIQUE RICARDO GRISONI Director 480-512-6514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: AZ 28876) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2007-07-18 |